The U.S. Preventive Services Task Force yesterday issued updated colon cancer screening guidelines, recommending against screening people older than age 75. Breaking with recommendations from the American Cancer Society and other radiology and gastroenterology groups, the task force also did not recommend CT colonography and a stool DNA test as screening modalities for colon cancer, citing insufficient evidence of those tests’ benefits and risks, according to the recommendations, which are published online today in the Annals of Internal Medicine.

Summary of Recommendations

· The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years.

· The risks and benefits of these screening methods vary. Go to the Rationale and Clinical Considerations sections for comparisons of the risks and benefits of different screening regimens, as well as the specific intervals for different recommended tests.

· The USPSTF recommends against routine screening for colorectal cancer in adults age 76 to 85 years. There may be considerations that support colorectal cancer screening in an individual patient.

· The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years.

· The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic colonography and fecal DNA testing as screening modalities for colorectal cancer.